Gastrointestinal Tract, Liver and Chronic GVHD

Chronic GVHD can affect the liver and gastrointestinal (GI) tract and cause abnormal liver function tests, difficulty eating and weight loss.

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Gastrointestinal Tract 

Chronic GVHD sometimes affects the esophagus, stomach and colon. Symptoms may include:

  • difficult or painful swallowing
  • anorexia (no desire to eat)
  • abdominal pain, bloating, cramping
  • greasy stools, undigested food in stool
  • weight loss
  • nausea, vomiting and diarrhea

If chronic GVHD affects your gastrointestinal tract, your doctor may recommend treatment with drugs that suppress the immune system or medications that coat the gastrointestinal tract with steroids without being absorbed into your system.  Extracorporeal photopheresis may also help control symptoms.

 If there are obstructions in the esophagus, called strictures or webs, a procedure called endoscopy may be used to clear them.


Chronic GVHD sometimes affects the liver. Symptoms may include:

  • elevated liver enzyme levels
  • jaundice (yellowing of skin and eyes)
  • dark urine
  • nausea and vomiting
  • anorexia (no desire to eat)

If you are diagnosed with chronic GVHD of the liver, your doctor may add ursodeoxycholic acid to the other drugs you are receiving to treat chronic GHVD.

Take Action!

  • Tell your doctor right away if you have symptoms of gastrointestinal GVHD. Other health issues can cause similar symptoms. It is important to rule these out so that you get proper treatment.
  • If weight loss is a problem, talk with a dietitian to develop a diet that will provide you with the calories, protein and nutrients you need to recover.  You can also order the free brochure Eating Well, Living Well after Transplant.

Click here to watch a video about Liver and GI GVHD.

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Next page: Genitals and GVHD

Updated June 2024